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Conversion of haemodialysis patients from iron sucrose to iron isomaltoside: a real-world experience

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journal contribution
posted on 18.03.2021, 12:58 by Jorge A Jesus-Silva, Archie Lamplugh, Sameera Dhada, James O Burton, Sunil Bhandari
Background
Anaemia is common in haemodialysis (HD) patients and associated with significant morbidity and mortality. Intravenous (IV) iron combined with erythropoiesis-stimulating agents (ESA) is the mainstay treatment of anaemia in these patients. The comparative efficacy and risk of adverse events with IV iron preparations have been assessed in only a few trials.

Methods
This was a retrospective observational study in 2 centres designed to compare the safety and efficacy of iron sucrose (IS-Venofer®) versus iron isomaltoside (IIM-Diafer®) in haemodialysis patients. The study included patients currently on dialysis and receiving Venofer who were switched to Diafer® and monitored for at least 12 months for each iron preparation.

Results
A total of 190 patients were included and had a mean age of 65.8 years (SD ± 15.5). Non-inferiority was confirmed with no change in mean haemoglobin per mg of iron administered over a 12-month period.

In total there were 41,295 prescriptions of iron isomaltoside and 14,685 of iron sucrose with no difference in the number of reported adverse events during the study period (7 each, none were severe).

There was a statistically significant effect on Hb over time after conversion, including adjustment for multiple comparisons. There were significant improvements in ferritin over time, which remained at 6 months (P < 0.01). The weekly iron dose was similar after adjustment (P = 0.02). The EPO dose did not differ significantly after month 0 in patients switched to IIM.

Conclusions
This study demonstrates the comparative safety and efficacy of iron isomaltoside versus iron sucrose, with similar dosing schedules in dialysis patients. Iron isomaltoside is non-inferior to iron sucrose in maintaining Hb in patients on regular haemodialysis/haemodiafiltration with no difference in the number of reported adverse events.

History

Citation

BMC Nephrol 21, 212 (2020). https://doi.org/10.1186/s12882-020-01866-x

Author affiliation

Department of Cardiovascular Sciences

Version

VoR (Version of Record)

Published in

BMC NEPHROLOGY

Volume

21

Issue

1

Publisher

BMC

issn

1471-2369

eissn

1471-2369

Acceptance date

25/05/2020

Copyright date

2020

Available date

18/03/2021

Spatial coverage

England

Language

English